Poor ultrasonic image quality is a significant problem for overweight and obese individuals. Often, these individuals receive poor quality and indeterminate diagnoses, which delay treatment. In addition, these individual may be referred to other imaging procedures that may increase costs and expose the patient to invasive procedures or ionizing radiation. We have developed a new ultrasonic imaging method, called Short-Lag Spatial Coherence (SLSC) imaging that has the ability to reduce acoustical noise and greatly improve the quality of ultrasonic images. We present preliminary data that demonstrates the success of this technique in human livers. In this application, we propose to build a real-time SLSC imaging system and analyze its characteristics with tissue-mimicking phantoms. In addition, we will build a harmonic version of this imaging technique, called Harmonic Spatial Coherence Imaging (HSCI) that improves clutter suppression and resolution of the imaging system. We also propose to develop the theoretical principles that describe this imaging technique, and will use these theoretical models to aid our development of more sophisticated versions of the proposed technique. We propose clinical studies in high BMI individuals undergoing ultrasound-guided percutaneous biopsies of focal liver lesions to evaluate the potential of this technique in improving the detection and characterization of those lesions.